Synopses & Reviews
Excerpt from The Ophthalmic Review, Vol. 17: A Record of Ophtalmic Science
On being admitted into the Dundee Royal Infirmary I made the following notesz - In the left eye there is well marked arcus senilis surrounding the cornea. In the centre Of the upper part of the iris there is a coloboma with symmetrical borders. As far as one can judge the coloboma is continued right up to the ciliary body, becoming slightly narrower as it passes upwards, being 5 mm. Below and 4 mm. Above. The pillars Of the colo boma are directly continuous with the pupillary margin and show no break. The sphincter iridis appears to be prolonged into the pillars of the coloboma. The pupil is 5 mm. In diameter, but on admitting strong light into the eye a well-marked contraction Of the pupil is Observed, which extends along both pillars, supporting the view that the sphincter is prolonged into the pillars. Under homatropine and cocaine drops the pupil dilates only to 7-50 mm., although unaffected by synechiae. On slight movement Of the eye well-marked iridodonesis is seen. The anterior chamber is deeper than usual. The lens is uniformly Opaque, and is dislocated downwards and back wards, the upper edge being visible about half way down the coloboma. Careful examination does not reveal the presence Of any fibres Of the suspensory ligament in the colobomatous area. It is impossible, on account Of the arcus senilis, to note the condition Of the ciliary body behind the coloboma, and for the same reason no view Of the fundus is obtainable with the Ophthalmoscope. The tension of the eyeball is normal, and perception and projection of light is good.
Before deciding on what should be done for him we kept him under very careful inspection for a fortnight. I soon convinced myself that if the lens could be got safely away the patient had a fair chance Of useful vision. Fearing considerable loss of vitreous, and also the probability Of the lens passing backwards either during or after thecorneal section, I thought couching might have been justifiable. Being, however, loath to revert to such an Objectionable method of dealing with an Opaque lens, I determined to remove it with the vectis, especially as I had been successful on previous occasions in removing dislocated lenses with that instrument.
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